Mobilization of Progenitor Cells and Vessel Healing After Implantation of Synergytm in Acute Coronary Syndrome

Abstract

This study was aimed to compare the vascular healing process of a SYNERGYTM stent with that of a PROMUS PREMIERTM stent in patients with acute coronary syndrome (ACS). In 71 patients with ACS, undergoing coronary stent implantation using the SYNERGYTM stent (n=52) or PROMUS PREMIERTM stent (n=19), we measured circulating CD34+/CD133+/CD45null cells and CD34+/KDR+ cells and observed vascular healing at the stented sites using optical coherence tomography (OCT) and coronary angioscopy. On the day 7, circulating CD34+/CD133+/CD45null cells increased in SYNERGY group (P<0.0001), while it did not change in PROMUS group. The CD34+/KDR+ cells also increased in SYNERGY group (P<0.0001) but less significantly in the PROMUS group (P<0.05). The OCT-based neointimal thickness (P<0.0005) and neointimal coverage rate (P<0.05) at 12 months were greater in SYNERGY group, compared with PROMUS group. The coronary angioscopy-based neointimal coverage grade at 12 months was also greater in SYNERGY group (P<0.001). In overall patients, the change in CD34+/KDR+ cells on the day 7 correlated with the OCT-based neointimal thickness at 12 months (R=0.288, P<0.05). SYNERGYTM stent seems to have potential advantages over PROMUS PREMIERTM stent for ACS patients in terms of vascular healing process at the stented sites.